SARS-CoV-2 infection in children - a review on clinical disease, transmission and school closures

Abstract

Coronavirus Disease 2019 has significant impact on societies and healthcare systems worldwide, but interestingly, children are less affected than adults. Infections with the severe acute respiratory syndrome coronavirus 2 have been reported in all age categories, including neonates, but occur less often in young children compared to adults. Moreover, the vast majority of children has mild disease and mortality is low. Immunocompromised children appear to have a higher risk of being admitted when infected and infection appears more severe in children with combined immunodeficiencies and immune dysregulation, in comparison to other immunodeficiencies such as antibody deficiencies. Children are less susceptible to infection than adults, and infectiousness appears to be either reduced or comparable. Vertical transmission is possible, but the risk hereof is very low. School closures have significant adverse impact on children, and because school outbreaks are relatively uncommon and strongly associated with regional incidence, school closures should be a last resort. Whether new variants of the virus might significantly change transmission dynamics remains unclear, and spread of these variants should be monitored carefully.